May 7, 2001

I'm sorry for my english. I'm
from Switzerland.Davide,m,64 I'm HIV + since '93. I first began the therapy last Year (06.00):viral load 100000,
Cd4 about 40. One month later
I began to get "strange" and for 4 weeks i had allucinations like people getting fat and thin or swinging in the street. They were visual allucinations, I was able to have quite normal dicussions at work or with friends but I was extremly sensible to people. The doctors(RM) found out a brain lesion and nothing else (no toxo, no cytomeg.,no...). The diagnosis was primary HIV encefalitis (PHE).Ijust went on with the teraphy. Now I'm o.k., but why am I not crazy? What's wrong? Is PHE = Aids dementia komplex or not? .September 2000 my Viral load was < 100 and Cd4 196 with Zerit, 3Tc and Viracept: they do not have a good penetration in brain cells! I had and have a very bad time. What shall I expect?

Response from Dr. Bartlett

The visual hallucinations you describe sound very disruptive. In the absence of another explanation, we sometimes attribute such problems to primary HIV encephalitis. This does not necessarily mean that you have, or will get HIV-associated dementia. Maximizing the suppression of HIV in your brain is important, and your doctors may want to measure an HIV RNA level in your cerebrospinal fluid. If it is detectable they could try another antiretroviral combination.

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